Individual provider Active NPI

Onochie Nnodu

  • Psychiatric/Mental Health Registered Nurse
  • Knoxville, TN
National Provider Identifier
1235449398
Registry record updated Jun 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
205 Issued in TN
Practice address
2350 McCampbell Wells Way
Knoxville, TN 37924-3128
Phone
(615) 554-1858
NPI assigned
Oct 7, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 205 TN Primary

Addresses

Primary practice location

2350 McCampbell Wells Way
Knoxville, TN 37924-3128

Mailing address

5310 Ball Camp Pike
Knoxville, TN 37921-3234
Phone (865) 523-4704

Other practice location 1

114 Beech Forge Dr
Antioch, TN 37013-2326
Phone (615) 554-1858

Other identifiers 1

IdentifierTypeStateIssuer
1235449398MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Knoxville

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
205TNMDPsychiatric/Mental Health Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1286409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561420800000",
    "number": "1235449398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 BALL CAMP PIKE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379213234",
            "telephone_number": "865-523-4704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 MCCAMPBELL WELLS WAY",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379243128",
            "telephone_number": "615-554-1858"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "114 Beech Forge Dr",
            "address_purpose": "LOCATION",
            "city": "Antioch",
            "state": "TN",
            "postal_code": "370132326",
            "country_code": "US",
            "telephone_number": "615-554-1858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NNODU",
        "first_name": "ONOCHIE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-07",
        "last_updated": "2019-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "TN",
            "license": "205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235449398",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Knoxville",
            "affiliation": "N",
            "address_1": "114 Beech Forge Dr",
            "city": "Antioch",
            "state": "TN",
            "country_code": "US",
            "postal_code": "370132326",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.